Surgeons Constitute Risk Factor for Infection After Colon Surgery

Surgeons can be an independent risk factor for surgical site infections after colon surgery

WEDNESDAY, July 20 (HealthDay News) -- Surgeons are found to constitute a risk factor for surgical site infections (SSI) in patients undergoing colon surgery, independent of other factors linked to the patient, the procedure, or the hospital where the intervention took place, according to a study published online July 18 in the Archives of Surgery.

Martin Hübner, M.D., from the University Hospital in Lausanne, Switzerland, and colleagues assessed the role of surgeons in the occurrence of SSI following colon surgery, with respect to their adherence to guidelines and their experience. A total of 2,393 patients, who underwent colon surgery performed by 31 surgeons in secondary and tertiary Swiss public hospitals between March and December 2008, were followed up for one month after their operation. Patient and procedure characteristics, hospitals, and surgeons were examined as risk factors for SSI.

The investigators identified SSIs in 17.9 percent of interventions, with individual surgeon rate varying between 3.7 and 36.1 percent, and hospital rate varying between 4.0 and 25.2 percent. The characteristics of patients and procedures correlating with SSI included male gender, age, American Society of Anesthesiologists score, contamination class, operation duration, and emergency procedure; whereas, correctly timed antibiotic prophylaxis and laparoscopic approach were protective. After adjusting for these characteristics and for the hospitals, a higher risk of SSI was observed for four surgeons and a lower risk for two surgeons. No association was seen between surgeons' individual adjusted risks and their adherence to guidelines or their experience.

"For reasons beyond adherence to guidelines or experience, the surgeon may constitute an independent risk factor for SSI after colon surgery," the authors write.